Clinical Interventions in Aging (Oct 2018)
Clinical efficacy and safety of donepezil in the treatment of Alzheimer’s disease in Chinese patients
Abstract
Nan Zhang,1,2 Marc L Gordon3,4 1Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Tianjin, People’s Republic of China; 2Department of Neurology and Neurosurgery, Tianjin Medical University General Hospital Airport Hospital, Tianjin, People’s Republic of China; 3The Litwin-Zucker Research Center, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; 4Departments of Neurology and Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA Abstract: Donepezil, an acetylcholinesterase inhibitor (AChEI), has been widely used to treat Alzheimer’s disease (AD) in China. However, there are few studies focusing on the efficacy and safety of donepezil in Chinese patients. In this review, we discuss 1) the efficacy of donepezil and its comparison with other AChEIs or memantine, 2) the therapeutic responses to donepezil and its influencing factors, and 3) the safety and tolerability of donepezil in Chinese patients with different stages of AD and amnestic mild cognitive impairment, and further compare the similarities and differences of the results between Chinese studies and previous Western studies that predominantly enrolled Caucasian subjects. We include Chinese clinical trials and other well-designed studies investigating donepezil or using donepezil as a positive control, in which the efficacy and/or safety of donepezil have been analyzed. Based on these studies, donepezil has been shown to be effective and safe in Chinese AD patients and may impact AD biomarkers, such as hippocampal atrophy, Aβ, and tau. In addition, the therapeutic response to donepezil may be influenced by apolipoprotein E or cytochrome P450 2D6 polymorphism. Keywords: Alzheimer’s disease, amnestic mild cognitive impairment, donepezil, acetylcholinesterase inhibitor, efficacy, safety
